Dr. Barnes is internationally recognized as an expert in the epidemiology of dementia. There are currently more than 6 million Americans and 55 millions people worldwide living with Alzheimer's disease and related dementias, and prevalence is expected to more than double by 2050. Dr. Barnes' research is designed to minimize the impact of the impending dementia epidemic using a three-pronged approach: 1) identifying modifiable risk factors for cognitive impairment and dementia in older adults; 2) developing dementia prediction models that can be used to estimate the impact of risk factor reduction and to target interventions toward those who are at greatest risk; and 3) testing interventions to delay onset or slow progression of cognitive impairment and dementia.
Much of Dr. Barnes' early research focused on performing observational studies to identify factors associated with increased or decreased risk of cognitive decline and dementia. She is particularly interested in the potential protective effects of physical, mental and social activity, as well as the effects of chronic health conditions such as depression, diabetes and hypertension. Together, these studies suggest that many risk factors for dementia are modifiable or treatable, raising hope that risk reduction interventions could potentially lower risk of cognitive impairment and dementia in late life.
Another major focus of Dr. Barnes' work has been on development of dementia risk models to identify older adults at risk of dementia in different settings and to forecast the potential impact of risk reduction interventions. In 2011, Dr. Barnes and Dr. Kristine Yaffe published a landmark article in Lancet Neurology in which they estimated that 30 to 50% of Alzheimer's and dementia cases are potentially attributable to 7 modifiable risk factors--physical inactivity, low education, smoking, depression, diabetes, mid-life hypertension and mid-life obesity--and that relatively small reductions in these risk factors at a societal level could potentially prevent millions of cases from ever occurring. These findings have subsequently been replicated and extended by several other groups and serve as the foundation for public health policy worldwide to reduce dementia risk. They also recently collaborated on a 2022 update in JAMA Neurology.
Dr. Barnes' most recent research is focusing on performing randomized, controlled trials (RCTs) to test interventions for delaying onset or slowing progression of dementia-related symptoms. With colleagues Dr. Wolf Mehling and Dr. Margaret Chesney, she led the development of a novel, mind-body, group movement program for people living with dementia call Preventing Loss of Independence through Exercise (PLIÉ). PLIÉ combines training procedural ("muscle") memory for basic daily movements, present-moment body awareness, and social connection through group movement. Dr. Barnes' research has found that PLIÉ has physical, cognitive, social and emotional benefits in people with subjective cognitive decline, mild cognitive impairment, and mild to moderate dementia in community, adult day and nursing home settings. Dr. Barnes' colleagues are currently studying implementation of a PLIÉ staff training program in VA nursing homes. In addition, Dr. Barnes co-founded a company called Together Senior Health to commercialize an online version of PLIÉ called Moving Together, and they are also studying a dementia risk reduction program called Brain Health Together.
Finally, Dr. Barnes is collaborating with Dr. Sascha Dublin at Kaiser Permanente Washington to improve detection and diagnosis of dementia in primary care. They developed and validated eRADAR (electronic health record Risk of Alzheimer's and Dementia Assessment Rule), which uses health record data to help identify patients who may have undiagnosed dementia. They are currently performing an embedded, pragmatic clinical trial of eRADAR to determine whether implementation of targeted screening improves diagnosis and patient care.